Audit in Occupational Health: 9

Mental Health consultations

These are important clinical encounters, may be difficult to audit and yet good practice is essential to achieve and maintain.
Stress is an increasingly common presentation of ill-health in occupational health practice. The evidence base for auditing the process of managing workers presenting with stress is not as good as it is for back pain. However there is probably an adequate consensus for a number of items to be included in the proces of a good practice consultation.

Give some thought as to what you think these might be, and then scroll down the page to the guideline framework which is provided as a starting point.
 
 
 
 
 
 
 
 
 
 

History
 

• Onset - Timing and description
• Reference to drug therapy
• Occupation - Title and tasks
• Qualitative and quantitative workload
• Relevant past history
• Enquiry about somatic symptoms
• Enquiry related to possible substance misuse
• Enquiry about social support

Examination

• Mental state examination - Affect
• Behaviour
• Intellect/Other higher functions

Diagnosis and Conclusions

• Nature of condition (Physical/Psychological)
• Possible causative factors - Occupational
• Non-occupational factors and other adverse health risks

Advice/Action

• Workplace assessment
• Advice on fitness for work
• Reduction of occupational stressors
• Reduction of other stressors

Remember:

Audit of consultations is only part of the audit that may be relevant to this important occupational health problem. It may need to be set in an organisational context. How would you audit the prevention of this type of occupational ill-health?

This page is:
http://www.agius.com/hew/audit/9.htm

You may also wish to access the following URL:
http://www.agius.com/hew/resource/quality.htm

Raymond Agius © Copyright 1995-2007

NOW.... Now consider carefully - perhaps in your workplace there are problems with respiratory or cutaneous sensitisation. How would you audit your clinical assessment of these cases? However, how would you audit the outcome? Once you have written your thoughts, then you may proceed to the next page.